The URL can be used to link to this page

09070156 CITY OF CUPERTIN O BUILDING PERMIT BUILDING ADDRESS: 21430 VAI AVE CONTRACTOR:JD PLUMBING PERMIT NO:09070156 OWNER'S NAME: GOVIND SUTLUR 270 UMBARGER RD STE 66 DATE ISSUED:07/22/2009 ER'S PHONE: 4082342834 SAN JOSE,CA 95111 PHONE NO:(408)646-3266 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r- PLUMB Li License Class `b 3Z� Lio# MECH RESIDENTIAL COMMERCIAL Contractor �� vf"� yt,^ Date O`Z c) ';f 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:SEWER LINE REPLACEMENT(PIPE BURSTING) (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. Y 1 hereby affirm under penalty of perjury one of the following two declarations: 1 have and will maintain a certificate of consent to self-insure for Worker's x4 Compensation,as provided for by Section 3700 of the Labor Code,for the Sq.Ft Flo&Afed Valuation:$4000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36205025.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: I with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature DateQ ZZ 0 GJ RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is OWNER-BUILDER DECLARATION installed without first obtaining an inspection,I agree to remove all new materials for inspection. 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: Signature of Applicant: Date: I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). HAZARDOUS MATERIALS DISCLOSURE I hereby affirm under penalty of perjury one of the following three I have read the hazardous materials requirements under Chapter 6.95 of the declarations: California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain a Certificate of Consent to self-insure for Worker's compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Compensation,as provided for by Section 3700 of the Labor Code,for the Safety Code,Section 25532(a)should I store or handle hazardous material. performance of the work for which this permit is issued. Additionally,should I use equipment or devices which emit hazardous air I have and will maintain Worker's Compensation Insurance,as provided for by contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Section 3700 of the Labor Code,for the performance of the work for which this health&Safety Code,Sections 25505,25533,and 25534. permit is issued. I certify that in the performance of the work for which this permit is issued,I shall Ow not employ any person in any manner so as to become subject to the Worker's Date: U 2 OCi1 Compensation laws of California. If,after making this certificate of exemption,1 become subject to the Worker's Compensation provisions of the Labor Code,I must CONSTRUCTION LENDING AGENCY forthwith comply with such provisions or this permit shall be deemed revoked. I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued(Sec.3097,Civ C.) APPLICANT CERTIFICATION Lender's Name I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating Lender's Address to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION nify and keep harmless the City of Cupertino against liabilities,judgments, L,, ,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature_ Date CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk:: Lot : APN . . . . . . . . : 36205025 . 00 DATE ISSUED. . . . . . . : 07/22/2009 RECEIPT #. . . . . . . . . : BSC00008243 REFERENCE ID # . . . : 09( 70156 SITE ADDRESS . . . . . : 21430 VAI AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : GOVIND SUTLUR ADDRESS . . . . . . . . . . : 21430 VAI AVE CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4935 RECEIVED FROM . . . . : JU1,N L DIAZ CONTRACTOR . . . . . . . : JUIN DIAZ LIC # 30298 COMPANY . . . . . . . . . . : JD PLUMBING ADDRESS . . . . . . . . . . : 27Cl UMBARGER RD STE 66 CITY/STATE/ZIP . . . : SAN JOSE, CA 95111 TELEPHONE . . . . . . . . : (4(18) 646-3266 FEE ID UNIT QUANTITY l,MOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -- -------- ---------- ---------- ---------- 1BCBSC VALUATION 4, 000 . 00 1 . 00 0 .00 1 . 00 0 . 00 1BSEISMICR VALUATION 4, 000 . 00 0 . 50 0 . 00 0 .50 0 . 00 1PPERMITFE FLAT RATE 1 .00 42 . 00 0 . 00 42 . 00 0 .00 1PRSEWER UNITS 1 .00 21 . 00 0 . 00 21 . 00 0 .00 1TRAVDOC FLAT RATE 1 .00 42 . 00 0 . 00 42 . 00 0 .00 -- -------- ---------- ---------- ---------- TOTAL PERMIT 106 .50 0 . 00 106 .50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 106 .50 VISA --------------- TOTAL RECEIPT 106 .50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 106 SEWER & WATER 202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING 400 SEWER/LATERAL 507 FINAL PLUMBING 09 �� 1 CITY OF CUPERTINO REPIPE/SEWER/MAIN SERVICE CUPEkTINO PERMIT APPI--JICATION FORM APN # " �� v Date: Z Building Address: a z I \f CA o -Q Owner's Name: Phone#:A 0� a34 -2e3-4 Contractor: \ Phone#: IQ6 —64 6--3 L 6 6 Fax #: +-:Af 36o Contact: o Phone#: I dg_ S6 9 " Cf 6 e-Z Fax #: 360 —'CC1( 6' Contractor License#: 89 6'32 k Cupertino Business License#: Job Description: 6 sC,t,•Wc9 Residential Commercial ❑ Valuation: .41000 - /0OO Project Size: Express Standard Large Major Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the application or if applicable, include in plan set& the sheet index. Green Building Points: Quantity Fee ID Fee Description Fee Permit Type Group 1PCSEWER Commercial building P 1CPSS sewer/sanitary:,ewer 1BPREPIPE Commercial re-pipe per fixture P 1CPRP 1 PGASCOM Commercial Gz s Piping System P 1-4 Outlets 1BCBSC Cal Bldg Standards Commission B ALL PERMIT Fee TYPES 1BSEISMICOM Seismic Commercial P Revised 01/07/09 CITY OF CUPERTINO r } ` REPIPE/SEWER/MAIN SERVICE CITY Of CUPERTINO FEE SCHEDULE Quantity Fee ID Fee Description Fee Permit Type Group 1 BCBSC Cal Bldg Standards Commission B ALL PERMIT Fee TYPES 1BSEISMICR Seismic Residential P ' 1PRSEWER Residential building P 1RPSS sewer/sanitary sewer 1PRREPIPE Residential re-pipe per fixture P 1RPRP 1BPWSVCS Water'Service P 1CPWS or 1RPWS 1PPRSEWG Private Sewage Disposal System P 1PCESS Cesspool P 1 BPWATER Install/alter Water Pipe P 1 BPFIXTURE Plumbing Fixture P 1 PGASRES Residential Gas P.ping System P 1-4 Outlets 1 BPGAS Gas Piping System 5+ Outlets P N 1PPERMITFEE Plumbing Permit lee Issuance P 1 PLMBLNCK Plumbing Plan Check P 1PLMBINSP Other Plumbing/gas Insp. P 1 TRAVDOC Travel & Docume atation Fee B 1 BUSLIC Business License B M.Indoor Air Quality and Finishes 1.Use LowNo-VOC Palf4 1 IADJHealth pts y--yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes. 7 D 3.Use LowNo VOC Adhesives 31AQ/Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes D 6.Use Exterior Grade Piywoodfor Interior Uses 1 IAQ/Health pts y=yes 0 7.Seel 41 Exposed Partideboar3d or MDF 4 IAQ/Health. pts y=yes 0 S.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0 9,Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0 1 ! 1 N.Flooring I= 1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes D 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 iEd Total Points Available: 140 1301 57 Total Points Project Received: 01 01 0 o 711Z2- G:datalprogsrgre;nbuildngguidelines/remodelers/greenpointsfinal212.o4protected.xls --:j, Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408)777-3228 CITY CSF Fax(408)777-3333 �UPERTINO Building Department JOB ADDRESS: � A �� PERMIT #�a�O, 3C7 -Z ( �� OWNER'S NAME: 6 c)-4d�,� So T- vv/" PHONE # 466 Z34 -7,?3---1 GENERAL CONTRACTOR: ' _,,,,r FAX # 4c-d 3co I am not using any subcontractors: 0Q- 2 C4 Si;:mature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile d.7l*=kl caner/Contractor Signature Date DISTRICT MANAGER-ENGINEER B ��® aP� OARD OF DIRECTORSMARK THOMAS&COMPANY,INC. � 1 50� � 9TE W1-!EN C_ANDREWS DAVID E.ROSS v 1 WILT-IAM A.BOSWORTH DISTRICT COUNSEL, YFAP S OF JOHN M.6ATT0 VP �� ATKINSON•FARASYN,LLP, CURTIS B.HARRISON HAROLD S.70PPEL AIg��,� WENDELL H.KEERR,JR. 20839 STEVENS CREEK BOULEVARD,SUITE 104 CUPERTINO,CI LIFORNIA 95014.219x1 (408)2'83"7071 PHONE • (409)25"179 rAX www,cup ertinossnitarydistrict.com T ile: CuSD MOP Building Dept. –Cupertino City of Cupertino AM..: Building.Department 10300 Torre Ave. Cupertino, CA, 95014.-3202 Subject: Sewer kine Replacement(Pipe Bursti>xg) Name: Govind Sutlur Residence Address: 21430 Vai Avenue APN: 362-05-025 Permit No. 090701.56 Backflow installed.behind property c/o ■ Videotape and Property Lane Cleanout inspected. No additional conditions/requirements by the District Inspector: Ge t /Ro er Santos/Joseph Sullivan.......... ............ Date:-07-28-09................... Sanitary Sewer Location: cc: Property Owner L/pl zs'Long 41' Deep 5' SUPPLYING SANITARY SEWERAGE SERVICES FOR;CITY OF CUPERTINO,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND SURROUNDING UNIN'ORPORATEO AREAS